Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QG0300X | Family Doctor - Geriatric Medicine | 04209 | KY |
NPI | 1073957163 |
---|---|
Provider Name | Brittany Calico |
First Address | Cincinnati, OH 45263-5283 |
Second Address | Fort Thomas, KY 41075-1793 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2013 |
Last Update Date | 08/03/2021 |